Friday, January 14, 2005


Quality of Life

Joe Carter at Evangelical Outpost has a post on the slippery slope of euthanasia that the Royal Dutch Medical Association finds itself sliding down. This got me to thinking about the U.S. healthcare industry's own steep slope.

There is no such formal standard for euthanasia in the U.S. (the Oregon assisted suicide law not withstanding). However, there is an informal protocol roughly adhered to by many healthcare providers in the U.S. It deals with resuscitation status (DNR, Partial code, Full code). What is said, we are all treated the same until breathing stops, and what is implied differ greatly. The devil is not in the details so much as it's in the delivery.

My point is simple, in general, DNR patients aren't treated the same as other patients. The DNR designation in their chart says to many "this patient has no quality of life" and they're better off dead. I hate the DNR status, not for what it is supposed to do, spare the terminally ill from futile resuscitation efforts, but from the reality of what it's become. DNR is the mark of Cain, without the promise of a curse from God if they're killed.

I can easily guess the code of a patient without ever looking at their chart simply by the reaction of hospital and nursing staff to certain orders I write. For example, I am treated with mild scorn for ever using the Critical Care Unit (CCU) to treat a DNR. This shouldn't be that way. I am to treat a DNR the same as any other until the point of death. But DNR's have no "quality of Life" (think, not quite human) and I'm just wasting precious space and resources on a lost soul.

Or maybe souless life would be a better term. Ah, now that's cutting to the heart of the rot I think. In our race to carve God out of everything, we've found that the sword is two edged. Without the view that all human life is equally precious because we are the image of the creator, we view life in degrees, we stratify who is most deserving to live.

Hitler must be smiling about now.

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